ORIF Proximal Humerus Fracture

An approximately 8-10 cm incision is made over the front of the shoulder. The fracture pieces are identified and brought into a more anatomic position. A plate is fixated to the bone to support the fracture while the bone is healing. Fluoroscopy (X-ray beam) is used to confirm anatomic position of the pieces. The incision is then closed with absorbable sutures, and dressings are applied. The patient will wake up with a sling in place. 

• This surgery is performed under general anesthesia with a nerve block.
• This surgery is usually outpatient, which means the patient generally goes home the day of surgery.
• Surgery typically lasts 1-1.5 hours.
• A sling will be fit at a preop appointment before surgery and will need to brought to surgery.
• The sling will be placed on the patient prior to waking up from anesthesia.
• The incisions will be closed with absorbable sutures, and a waterproof dressing will be applied. This should be left in place until the first postop appointment.
• The patient may shower right away as long as there is a good seal of the waterproof dressing. 

• Patients with a displaced fracture
• Patients with poor bone quality that may lead to lower chance of healing
• Patients who desire a quicker return to sports and activity

Recovery following an open reduction internal fixation of a proximal humerus fracture is several months. Patients will be placed in a sling for 4 weeks after surgery. Patients are limited to elbow range of motion and pendulum exercises for this period of time. Physical therapy (PT) will start about 2 weeks after surgery and will last for a few months, depending on the progress that is made. Physical therapists follow a prescribed protocol outlined by Dr. Faulkner to regain range of motion and strength. Physical therapy and home exercises are a critical part of a patient’s outcomes and quality of life after surgery. The patient should expect to continue to improve with range of motion and strength up to 1 year after surgery, with most of the gains occurring within the first few months after surgery. The patient should plan on being seen in clinic about every 6 weeks for 3-4 months after the surgery for close monitoring and to ensure any questions are answered.